Critical Incident Response for Workplace Violence

Transcription

1 Attridge & VandePol 1 Critical Incident Response for Workplace Violence Mark Attridge, PhD, MA Bob VandePol, MSW For publication in The Workplace Violence Prevention e-report July 18, 2011 Word count = References Critical incidents involving workplace violence are sudden, unexpected, often lifethreatening time-limited events that can inhibit an individual s capacity to respond adaptively. This report summarizes the extent of the problem, the psychological aspects of trauma from workplace violence, how it is treated through critical incident response services, and the business value of providing a proper response and prevention strategy. Workplace Violence Prevalence A survey by the United States Bureau of Labor Statistics found that about 5% of all businesses experienced an incident of workplace violence each year, with this rate being much higher at 50% for larger size organizations with over 1,000 workers. 1 An average of 5 violent crimes are committed at work each year per 1,000 employees in the US. 2 Data from crime reports in the US indicates that in 2009 there were over 500 homicides in which someone was killed at work. 2 In addition, of the non-fatal violence at work, 78% were simple assaults and 22% were serious violent crimes (i.e., aggravated assault 17%, robbery 3% and rape/sexual assault 2%). 2

2 Attridge & VandePol 2 Workplace Violence Consequences The impact of violent incidents experienced at work can be debilitating and stems from recurrent intrusive images, persistent fear, displaced anger, guilt, and isolation. Extreme critical incident stressors can even result in personal crises, traumatic stress, and post-traumatic stress disorder (PTSD). When one person willfully harms another it breaches legal, ethical, and the way it s supposed to be boundaries. Persons bereaved by violent causes have more PTSD, grief, and depression symptoms than those bereaved by natural causes. In addition to their human toll, workplace violence incidents are disruptive to both corporate business and workplace operations. Productivity, quality, profitability, and other financial measures are adversely affected by such events. Critical Incident Response to Trauma Immediate application of psychological first aid that helps people access personal strengths and resiliency supports is crucial to reverse self-attribution from victim to survivor. 3 Critical Incident Response (CIR) refers to an integrated comprehensive, multi-component, crisis intervention approach for addressing the psychological consequences of critical incidents. 4 CIR can accomplish psychological closure, prevention, and mitigation of traumatic stress, and promote return to normalcy, benefiting the individual, organization, and the community at large. CIR services are now commonly used in the United States and in many other countries around the world and are often included as part of a broad range of services offered to organizations by employee assistance programs. Clinical Effectiveness of CIR According to the dozens of research studies, when CIR services are properly delivered they are often helpful in reducing the symptoms of severe stress that affect individuals who have

3 Attridge & VandePol 3 experienced a workplace trauma or other critical incidents such as violence. 5 Many studies also support for the general effectiveness of trauma-focused cognitive-behavioral therapy (CBT) and other acute care psychotherapies in the treatment of individuals with more serious kinds of post crisis mental health problems. 6 Business Outcomes of CIR A recent literature review examined the evidence for the business value for employers who provide CIR services. 7 In addition to risk management and reducing company legal exposure for workplace-related traumatic incidents, financial benefits have most often been found in reductions in disability claims, workers compensation claim costs, absence days, health care costs and also in avoided employee turnover. Some case examples offer evidence of the business impact of CIR services: Case Example 1. A study examined company data before and after initiating a CIR program following violent bank robberies. 8 Data from over 100 employees was used to compare worker absence days and combined medical and worker s compensation costs for the year before the CIR program to the following year after implementing a CIR program. Results showed that worker absence days experienced in the week just after the robbery were reduced by 60% (from average of 2.81 days missed per employee before CIR to 1.12 days after) and were also reduced by 60% in the longer term in the six month period following the robbery (from 6.68 days per employee before to 2.65 days after) and average medical benefits and other workers compensation costs were reduced by 66% (from $18,488 average per employee for the period before CIR to $6,326 after). Case Example 2. Family Dollar is a chain of over 6,700 retail stores in the US. 9 In 2007, the company put in place additional services to increase the number of employees returning to

4 Attridge & VandePol 4 work where serious injury had occurred or the employee had not returned to work after the CIR intervention. When team members received professional support immediately after a traumatic incident (i.e., within 2 to 24 hours) the company retained 86% of their employees and only 6% of employees filed a worker s compensation claim. In addition, the costs for these workers compensation claims were 15% less costly than those from prior periods before the CIR program. Summary There is strong research support the clinical effectiveness of CIR and related psychological first aid kinds of workplace mental health support services. The research support for the business case for CIR is positive but only emerging in terms of the number of studies and of the sophistication of the study designs. Of course, it is far better to avoid a violent incident at work that to treat the trauma that can result. There are workplace violence prevention programs that have been shown in research to reduce the incidence rates for violent crime in high-risk settings of hospitals 10 and retail and service establishments. 11 Thus, organizations are advised to consider adopting prevention and intervention programs for potential workplace violence. A useful resource for employers is the 2009 report by the US Occupational Safety and Health Administration (OHSA) on evidence-based recommendations for workplace violence prevention programs. 12 AUTHOR1: Mark Attridge is president of Attridge Consulting, Inc., Minneapolis, MN. He can be reached at (612) or mark@attridgeconsulting.com AUTHOR2: Bob VandePol is president of Crisis Care Network, Grandville, MI. He can be reached at (888) or bob.vandepol@crisiscare.com

5 Attridge & VandePol 5 REFERENCES [1] Bureau of Labor Statistics. (2005). Survey of workplace violence prevention. Washington, DC: Author. Available from: [2] Harrell, E. (2011, March). Workplace violence, : National crime victimization survey and the census of fatal occupational injuries. Special Report #NCJ Washington DC: US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. Available from: [3] VandePol, B., Larbadee, L., & Gist, R. (2006). The evolution of psychological first aid. Journal of Employee Assistance, 36(2), [4] VandePol, B., Gist, R., Braverman, M., & Labardee, L. (2006). Strategic specialty partnerships: Enabling the EAP for evidence informed best practices in workplace crisis response. Journal of Workplace Behavioral Health, 21(3/4), [5] Everly, G. S., Jr., Sherman, M. F., Stapleton, A., Barnett, D. J., Hiremath, G. S., & Links, J. M. (2006). Workplace crisis intervention: A systematic review of effect sizes. Journal of Workplace Behavioral Health, 21(3&4), [6] Roberts, N. P., Kitchiner, N. J., Kenardy, J., & Bisson, J. I. (2009). Systematic review and meta-analysis of multiple-session early interventions following traumatic events. American Journal of Psychiatry, 166(3), [7] Attridge, M., & VandePol, R. (2010). The business case for workplace critical incident response: A literature review and some employer examples. Journal of Workplace Behavioral Health, 25(2), [8] Leeman-Conley, A. (1990). After a violent robbery. Criminology Australia, 1(4), 4-6. [9] Partnership for Workplace Mental Health. (2009). Employer Innovations Online: Family Dollar. Arlington, VA; Author. Available from: [10] Flannery, R. B. (2008). Crisis intervention services and empirical data: Lessons learned from the Assaulted Staff Action Program (ASAP). International Journal of Emergency Mental Health, 10(4), [11] Casteel, C., Peek-Asa, C., Greenland, S., Chu, L. D., & Kraus, J. F. (2008). A study of the effectiveness of a workplace violence intervention for small retail and service establishments. Journal of Occupational and Environmental Medicine, 50(12), [12] Occupational Safety and Health Administration. (2009). Recommendations for workplace violence prevention programs in late-night retail establishments. OHSA Report # R. Washington, DC: US Department of Labor / OHSA. Available from: